The NanoString nCounter Flex Analysis System is manufactured by NanoString Technologies, Inc. (Seattle, WA), who were the original developers of this technology and remain the sole manufacturer and provider of the technology. The MVAHCS currently does not have this equipment. MVAHCS has a long tradition of translational research, a notable example being the adoption of the Gleason grading system for prostate cancer developed at this institution. However, in the present era it is critical that clinicians and basic scientists have at their disposal cutting-edge, state of the art instrumentation to rapidly acquire reliable data for investigations with potential of leading to clinical translation. The Nanostring is designed to provide direct digital counting of signals such as RNA, miRNA, DNA copy number, ChIP DNA, and protein ? all from the same sample which can be as small as nanogram quantity. Samples for analysis can be serum, plasma, FFPE tissue, fresh or frozen tissue, cells, and exosomes. Expression of various signals is analyzed in a cartridge-based DNA/RNA/Protein expression analyzer. Combined sample analysis for sequential testing eliminates bias inherent in splitting samples and using different analysis methods, allowing direct correlation between signals in a given sample. Data are available within 24 h. The platform can be used for pre- designed human, mouse and rat work or for custom work on various targets or species of interest (up to 770 genes in the same sample). NanoString Technologies staff provide custom design services at no cost to analyze desired signals; the only cost is for the purchase of the preformatted arrays or cartridges containing the capture and reporter probes which together provide a unique molecular barcode. The machine requires only minimal training (about 30 min). The system runs the same exact chemistries as the FDA approved tests and thus provides a platform for rapid transition of pre-clinical and clinical investigations to the clinical arena. No bioinformatics are required to access data, so that the statistical support available at MVAHCS is sufficient for retrospective and prospective patient and animal studies. The technology has strong potential of application in a range of studies including Gulf war illness, lung disease, neuropathology, infectious disease, inflammation, immune-oncology, autoimmune disease, obesity and various cancers. The technology has the most advanced capability of identifying potential biomarkers for disease identification, progression, and therapy decisions, such as miRNA, mRNA, and protein signatures from serum of prostate cancer and HNSCC patients, to identify their correlation between tissue signatures and disease status in retrospective and eventually prospective studies. These data may enable us to predict disease progression and response to therapy, and yield information of value for the clinical management of the disease in the patients (i.e., personalized medicine). If funded, the instrument will be housed within a dedicated imaging room in the MVAHCS. Dr. Ahmed will work with the MVAHCS Research Office to oversee the training and usage of the equipment under the full support of MVAHCS Director and the R&D Committee Chair. The identified major and minor users collectively represent numerous VA research disciplines from both basic and translational research (neuroscience, Alzheimer's and Parkinson's disease, cardiovascular research, liver and pancreatic cancer, prostate cancer, breast cancer, head and neck cancer, melanoma, stem cell therapies, obesity, and Gulf War Illness). At least 75% of the instrument capacity will be used by VA funded researchers and about 25% will be occupied by minor users. In order to maintain the status of the MVAHCS as one of the largest and most active research programs, it is critical that cutting edge technology be available to our researchers. The addition of the NanoString nCounter analysis system would facilitate research to address the specific needs of US Veterans. Further, this would foster multidisciplinary collaborations between MVAHCS colleagues and promote collaborative, benchtop to clinic translational science that would benefit all Americans.